CN103800049B - Targeting device for guiding drilling apparatus - Google Patents
Targeting device for guiding drilling apparatus Download PDFInfo
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- CN103800049B CN103800049B CN201310556203.4A CN201310556203A CN103800049B CN 103800049 B CN103800049 B CN 103800049B CN 201310556203 A CN201310556203 A CN 201310556203A CN 103800049 B CN103800049 B CN 103800049B
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/16—Bone cutting, breaking or removal means other than saws, e.g. Osteoclasts; Drills or chisels for bones; Trepans
- A61B17/17—Guides or aligning means for drills, mills, pins or wires
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/16—Bone cutting, breaking or removal means other than saws, e.g. Osteoclasts; Drills or chisels for bones; Trepans
- A61B17/1642—Bone cutting, breaking or removal means other than saws, e.g. Osteoclasts; Drills or chisels for bones; Trepans for producing a curved bore
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/16—Bone cutting, breaking or removal means other than saws, e.g. Osteoclasts; Drills or chisels for bones; Trepans
- A61B17/17—Guides or aligning means for drills, mills, pins or wires
- A61B17/1717—Guides or aligning means for drills, mills, pins or wires for applying intramedullary nails or pins
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/16—Bone cutting, breaking or removal means other than saws, e.g. Osteoclasts; Drills or chisels for bones; Trepans
- A61B17/17—Guides or aligning means for drills, mills, pins or wires
- A61B17/1721—Guides or aligning means for drills, mills, pins or wires for applying pins along or parallel to the axis of the femoral neck
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/16—Bone cutting, breaking or removal means other than saws, e.g. Osteoclasts; Drills or chisels for bones; Trepans
- A61B17/17—Guides or aligning means for drills, mills, pins or wires
- A61B17/1725—Guides or aligning means for drills, mills, pins or wires for applying transverse screws or pins through intramedullary nails or pins
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/16—Bone cutting, breaking or removal means other than saws, e.g. Osteoclasts; Drills or chisels for bones; Trepans
- A61B17/17—Guides or aligning means for drills, mills, pins or wires
- A61B17/1728—Guides or aligning means for drills, mills, pins or wires for holes for bone plates or plate screws
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/16—Bone cutting, breaking or removal means other than saws, e.g. Osteoclasts; Drills or chisels for bones; Trepans
- A61B17/17—Guides or aligning means for drills, mills, pins or wires
- A61B17/1739—Guides or aligning means for drills, mills, pins or wires specially adapted for particular parts of the body
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/56—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
- A61B17/58—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws, setting implements or the like
- A61B17/68—Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
- A61B17/72—Intramedullary pins, nails or other devices
- A61B17/7291—Intramedullary pins, nails or other devices for small bones, e.g. in the foot, ankle, hand or wrist
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/56—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
- A61B17/58—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws, setting implements or the like
- A61B17/68—Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
- A61B17/84—Fasteners therefor or fasteners being internal fixation devices
- A61B17/846—Nails or pins, i.e. anchors without movable parts, holding by friction only, with or without structured surface
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/16—Bone cutting, breaking or removal means other than saws, e.g. Osteoclasts; Drills or chisels for bones; Trepans
- A61B17/17—Guides or aligning means for drills, mills, pins or wires
- A61B17/1739—Guides or aligning means for drills, mills, pins or wires specially adapted for particular parts of the body
- A61B17/1775—Guides or aligning means for drills, mills, pins or wires specially adapted for particular parts of the body for the foot or ankle
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- Oral & Maxillofacial Surgery (AREA)
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- Surgical Instruments (AREA)
Abstract
One kind is used to guide drilling apparatus（11、12）Targeting device（1）, the drilling apparatus in the component of adjacent bone or bone chip for forming arcuate socket, and the targeting device includes：Support frame（2；5；7）；Pivoting device（8）, the pivoting device is installed to support frame（2；5；7）And it is arranged to receive drilling apparatus（11；12）With permission drilling apparatus（11；12）Along with predetermined bend radius rcCurved path surround pivot axis（9）Pivoting action.Support frame（2；5；7）With at least three fixing devices（3；4；6）, when bone component is installed to support frame（2；5；7）When each fixing device be configured to fix one of bone of bone component（14；15；16）Or fragment is with relative to pivoting device（8）Limit bone component（14；15；16）Fixed position in space.
Description
Technical field
The present invention relates to the targeting device for guiding drilling apparatus, the drilling apparatus is used for respectively in adjacent bone or bone
Arcuate socket is formed in the component of fragment.
Background technology
Device is targetted from a kind of seal wire of arthrodesis for being used to help heel known to file WO2011/072249A1, its
Allow using be angled with respect to each other seal wire formation separately begin from the bottom of calcaneum and towards shin bone pipe extend through away from
The straight cutting path of two of bone.Rig and reamer are used after targeting device is removed, can set up curved according to the combination in path
Curved hole or pipe, it can receive fixed nail.Tubular sleeve is used to target in device with guide wire straight through bone material.
But the shortcoming of this method is to increase bone material damage, reason is using two cutting paths.In addition, when in hand
It is related to the bottom timesharing of calcaneum during art, patient can suffer from pain.Moreover, the duration always configured and stability may
It is unsatisfactory.So, some surgeries application in, in recent years additionally need formed in bone material be not generally should
The hole of straight shape.
Some in those applications are related in a bone or get out arcuate socket in the component of multiple adjacent bones.
A kind of device for being used to form curved channel in vertebra is for example proposed in US2005/0267481A1, wherein
Two path protecting components being connected to each other via platform assembly attach each vertebra respectively by multiple nails.At platform
Pivotal arm keep arc duct member, driving cable extend through the arc duct member, the driving cable is driven by motor
So as to be rotatably disposed in the drill bit at the front end of duct member.Due to the arc of pipe, it can be got out when pivotal arm advances towards bone
Arcuate socket.In this manner, interverbebral disc is directly connect by the arcuate socket that is cut in adjacent vertebral and by its corresponding end-faces
Closely.
Another device for forming arcuate socket is described in US2010/0292722A1.The device include by means of gram
Family name's pin（Kirschner-wire）The main body of the heel of human body is attached to, and arc guiding piece can be guided with corresponding curvature
Radius rcPipe to perform pivoting action.The device is attached to heel at two positions.By motor via extending through pipe
The drill bit of driving cable actuated initially enters calcaneum, and arcuate socket is advanced through the marrow space that astragalus enters shin bone
In.The arc-shaped hole so formed allows the corresponding nail for inserting fixed related bone.
The content of the invention
Device is targetted it is an object of the invention to provide one kind, it improves the accuracy of boring procedure, or allows to drill
The more accurate control of journey.
The purpose is realized by targeting device according to claim 1.
Target device and at least three different fixing devices are provided, it allows each single bone or bone of fixing bone component broken
Piece.Fixing device is provided as being arranged at common frame.Pivoting device is also provided and is configured to may be mounted to framework.Pivot
Rotary device keeps drilling apparatus and allows to promote drilling apparatus by the pivoting action performed along the curved path in plane.
The position of bone component is defined completely due to three fixing devices by three-point mount in space.Therefore,
Drilling curved path along which is carried out by the pivoting action of drilling apparatus to fix relative to bone component.Therefore, will not occur
The deviation and the accuracy of arcuate socket of drift etc. are enhanced.When may be inserted into cuved nail afterwards, this is probably important
, cuved nail is designed to fix bone component, and the shape of cuved nail necessarily corresponds to the arc in hole.
In a specific embodiment, targeting device includes drill jig.Drill jig have allow before drilling, period or
The holder part of the position of arcuate socket is indicated afterwards.Drill jig can be provided as the part independently of pivoting device, or
It can also be formed as being connected with pivoting device.Drill jig can be surrounded and pivoted with pivoting device identical pivot axis.At one
In specific embodiment, drill jig and pivoting device can be provided as from the removable independent sector of framework, wherein in targeting
A part during use for device is by another partial replacement.
Brief description of the drawings
The other feature and advantage of the present invention will become obvious by means of accompanying drawing from the description of embodiment.In the accompanying drawings：
Fig. 1 shows the targeting device and the total figure of drilling apparatus according to specific embodiment in the perspective；
Fig. 2 shows the details of the main support member as shown in Figure 1 with the first and second fixing devices in the perspective；
Fig. 3 shows the as shown in Figure 1 first pivotable support section attached with the 3rd fixing device in the perspective
Details；
Fig. 4 A show the as shown in Figure 1 second pivotable support section attached with the 3rd fixing device in the perspective
Details；
Fig. 4 B show the enlarged drawing of Fig. 4 A of the pattern with rib C-shaped receiving portion；
Fig. 5 shows the details of pivoting device as shown in Figure 1 and drilling apparatus in the perspective；
Fig. 6 shows the details of drill jig as shown in Figure 1 in the perspective；
Fig. 7 shows the details for the bone anchor assembly with tulip shaped head being used in combination with Fig. 1 targeting device；
The step of Fig. 8 shows the targeting device using Fig. 1 in the perspective view of heel in side view, wherein with root tuber of aromatic turmeric
Two bone anchor assemblies in fragrant forming head portion are inserted in calcaneum and astragalus respectively；
Fig. 9 is identical with Fig. 8 but is shown in front view；
Figure 10 is identical with Fig. 8 but is shown in rearview；
Figure 11 shows the other step using targeting device, wherein Kirschner wire to schematically show in the perspective view of people's pin
（Dotted line）Insert to reposition the bone of heel；
Figure 12 A displays are using the other step for targetting device, and wherein people's pin is installed to master with the first and second fixing devices
Support member（Soft tissue portion is not shown）；
Figure 12 B are shown in the tulip shaped head of bone anchor assembly and the end from the pin being located at the first fixing device is protruded
Spherical head between the enlarged drawing of connection set up；
Figure 13 displays are using the other step for targetting device, wherein the first pivotable supporting part with the 3rd fixing device
Divide and be installed to main support member, and fixing device is fixed at shin bone；
Figure 14 displays are using the other step of targeting device, and wherein drill jig and the second pivoting portions swing to find the
The appropriate rotation position for the pivot axis that two pivot part offices are limited is with drilling bore hole；
Figure 15 displays replace drill jig and pivotal arm and drilling apparatus are attached to the another of the pivot axis of targeting device
Outer step；
Figure 16 is shown by pivoting the other step that the drill bit of drilling apparatus and circular arc pipe are advanced in hole by pivoting device
Suddenly；
The example of circular arc nail of Figure 17 displays insertion in the hole using the method formation for targetting device.
Embodiment
Keep and guide the embodiment of the targeting device 1 of drilling apparatus 11,12 to be shown in Fig. 1.Shown in Fig. 1
Component is ad hoc designed to that the bone drill of the heel by human body goes out arc-shaped hole.The application is particularly designed to perform the pass of metapedes
Section is fixed.Similar device can be configured to be applied to scope of the other parts without departing from appended claim of human body.
Fig. 1 provides total figure, and the details of its part is shown in Fig. 2 to 7, and wherein prepares people's pin and heel
Step, using targeting device the step of and operation drilling machine components the step of respectively in Fig. 8 to 16 be shown.It is compatible to and can
The nail being inserted through in the hole got out using the drilling apparatus according to Fig. 1-7 and the method according to Fig. 8-16 is shown in fig. 17
Show.
In Fig. 1, targeting device 1 includes the framework or frame frame for consisting essentially of main support member 2, and the main support member has
The first pivotable support section 7 of pivotable support section 5 and second.Main support member 2 is configured to receive the first and second fixations
The pivotable support section 5 of device 3,4 and first is configured to receive the 3rd fixing device 6.
The targeting device of the embodiment also includes pivoting device 8, and the pivoting device is suitable for keeping drilling tool 11 and had
The circular arc tube portion 12 of drill bit.Pivoting device 8 can be attached to rotary support member 72 at the second pivotable support section 7.
Rotary support member 72 limits pivot axis 9, and the pivot axis 9 is approximately perpendicular to by part 2,5 and 7 in this specific embodiment
The plane of erection.Rotatable drill jig 10 can also be attached to the rotatable support member of the second pivotable support section 7.In Fig. 1
In, pivoting device 8 and drill jig 10 are indicated as integral part.Due to constructed above, pivoting device 8 and drilling apparatus and brill
The plane that fixture rotates wherein is roughly parallel to the plane set up by frame part 2,5 and 7.
Shown in Figure 13 as described in more detail below, fixing device 3,4 and 6 is designed to be fixed on the bone component of heel
At bone or bone chip, calcaneum 14 is fixed in this specific embodiment（Fixing device 4）, astragalus 15（Fixing device 3）And shin bone
16（Fixing device 6）Place.In order to meet respective foot with specific anatomical structure, fixing device 3 and 4 can be relative in a linear fashion
In slideably adjusting each other, and the 3rd fixing device 6 can also slideably be adjusted on the first pivotable support section 5
Section.In addition, by rotate the first pivotable support section 5, the 3rd fixing device 6 can relative to two other fixing device 3,
4 position rotation.
On the right side of device, the second pivotable support section 7 can also rotate relative to main support member 2, wherein second can
Pivot support part 7 provides rotary support member 72, institute at the relative end part 7a of the end part 7b with being connected to main support member 2
Rotary support member is stated to limit for pivoting device 8 or the pivot axis of drill jig 10 with drilling apparatus 11,12.
Drilling apparatus includes drilling tool 11 and the tube portion 12 with drill bit 126, and the tube portion is received simultaneously by pivoting device 8
Keep.Tube portion 12 is circular arc, as shown in fig. 1.Tube portion 12, which has, corresponds to it from the curvature with a distance from pivot axis 9
Radius rcSo that when pivoting device 8 rotates around pivot axis 9, flexural center axis of the tube portion 12 along its own is moved
It is dynamic.Therefore, when the anglec of rotation of user's the second pivotable support section 7 of regulation relative to main support member 2, by tube portion 12 and brill
The circular or circle section path of first 126 motion portrayal can be positioned relative to the bone component of the heel of patient, and this will join below
Figure 14 is examined to be described in more detail.
The separate part of targeting device 1 and drilling apparatus 11,12 is illustrated in greater detail in Fig. 2 to 6.Fig. 2 shows main branch
The details of support member 2.The main support member 2 of the specific embodiment includes the guide rail 20,21 of parallel arrangement.In an end of guide rail
It is disposed with the first fixing device 3 and the second fixing device 4 is disposed with the other end.First fixing device 3 slidably and
Second fixing device 4 is fixed on guide rail 20,21.However, other embodiments can also allow two fixing devices 3,4 to slide
It is dynamic.
Second fixing device, which includes having, pinches wheel 41（It is fixed）It is bracket 42, base part 42, vertical from base part 42
The vertical portion 45 of extension, from the level of vertical portion 45 protrude pin 46 and be arranged in pin 46 end spherical head 47.
Wheel 41 is pinched to be arranged at the bottom of bracket 42 and be configured to below with reference to the C-shaped receiving portion 71 described in Fig. 4 A and 4B and micro-
The pattern of type rib 73 clamps or clutched end part 7b.
Pinching wheel 41 can be relative to cylindrical part（Do not show）Rotation, the cylindrical part has pinches wheel 41 with being located at
The screw thread of the screw-internal thread fit at place and limit vertical extension axis 92 to increased or decrease it towards the bottom surface of bracket 42
Distance.When the second pivotable support section rotates around above axis, pinching the manual fine-tuning of wheel allows to determine due to being located at the
Tactile response is expected caused by the pattern of the miniature rib 73 of the two pivotable sides of support section 7.It is arranged to and the second pivotably support
The pattern for the miniature rib 73 that rib 73 at part 7 coordinates（Do not show）Therefore it can also be located at the bottom surface of bracket 42.Work as both sides
Rib 73 when being fastenably engaged in the corresponding recesses between the rib 73 of opposite side, further tighten pinch that wheel 41 then allows second can
The last locking of the orientation of pivot support part 7.
Bracket 42 includes being used for the hole 43,44 for receiving guide rail 20,21 respectively, and also has vertical portion 45, horizontal pin
46 and spherical head 47, the part for fixing bone in pin end（More specifically, calcaneum）.Pin 46 and spherical head 47 are formed
The receiving portion of second fixing device 4.Thus, spherical head 47 is configured to the root tuber of aromatic turmeric of the bone anchor assembly 13 with showing in the figure 7
Fragrant forming head portion 130 interacts.Such bone anchor assembly 13 for the purpose is anchored at calcaneum by its threaded shanks 131
In.Spherical head 47 can be snapped into tulip shaped head 130, and the tulip head is flexible due to notch 132
Upper edge portion.
Connection between spherical head 47 and tulip shaped head 130 provides the fixation between targeting device 1 and bone component
Point（At least three）In one.In this specific embodiment, as long as setting up less than three fixing points, consolidated as described above by second
The ball-joint-like for determining device foundation is connected as the certain small freedom of motion of the multiaxis orientation offer of part relative to each other, finally leads
Cause the fixation of bone component in three dimensions.
As shown in Figure 2, the first fixing device 3 is slidably disposed on guide rail 20,21.The slidable adjustment of position and solid
It is fixed to be realized by screw 35.Similar to the second fixing device 4, there is the first fixing device 3 band to pinch the bracket 32 of wheel 31, vertical extension
Part 39, horizontal protrudent pin 37 and the spherical head 38 in its end.The ball of the function of spherical head 38 and the second fixing device
The situation in forming head portion 47 is identical.The receiving portion of pin 37 and the first fixing device 3 of formation of spherical head 38.As shown in figure 12a,
When people's pin is installed to main support member 2, pin 37,46 is flatly protruded towards the end face of astragalus and calcaneum respectively.（One or two
It is individual）The slip of bracket allows to contact the corresponding tulip shaped head 130 of the anchor 13 anchored to respectively in bone（Referring also to figure
8）.
Rotary support member 36 limits joint axis and is designed to receive the pin 55 of the first pivotable support section 5.Bracket
32 carry for receiving respective track 20,21 to allow the hole 33,34 along direction A slidable adjustment.
Fig. 3 shows the first pivotable support section 5, and the first pivotable support section includes elongate bars in this embodiment
50, and it is attached to the first fixing device 3 by means of the joint 52 for an end for being attached to bar 50.Joint 52 has with holes
Two ledges 53,54, pin 55 extends through the hole, and the pin is suitable for being connect by the guiding piece 36 of the first fixing device 3
Receive.Pin 55 can have one or two screw thread to be held in place when being installed to guiding piece 36.Pin 55 and guiding piece 36 are limited
Determine vertical-rotation-axis 91, elongate bars 50 can be pivoted around the vertical-rotation-axis.According to the rotation axis of the embodiment
91 or rotation axis 92 or two axis be parallel to pivot axis 9, however it is also anticipated that other be arranged obliquely.
Elongate bars 50 have the flat 51 for the slidable adjustment for allowing the 3rd fixing device 6, and wherein flat 51 is prohibited
Only rotation of the fixing device 6 around the axis of bar 50.In addition, fixing device 6 consists essentially of bracket 62 and fixed along bar 50
The screw 61 of the position of 3rd fixing device 6.
3rd fixing device 6, which also has, includes the receiving portion 63 of cylinder open 64, and the cylinder open is configured to
Receive Si Shi（Schanz）A part for screw 17, the situation is for example shown in fig. 13.In Si Shi screws insertion shin bone.This
Fixation of family name's screw in the cylindrical hole 64 of receiving portion 63 is ensured by screw 65.The connection provides bone component and targeting device
Between the 3rd and last fixing point.
Slidable adjustment of 3rd fixing device 6 along bar 50 is possible on the direction B shown in Fig. 3 and 13.
Fig. 4 A show the details of the second pivotable support section 7, and the second pivotable support section allows operator, for example outer
The circular arc path of section doctor or other artificial tube portions 12 determines pivot axis 9 or central point, and the tube portion has in pipe
The drill bit 126 of the end of shape main body 125.Second pivotable support section 7 includes elongated shaft part 70, at one end thereof
C-shaped receiving portion 71 and the prominent rotary support member 72 vertically at the 7a of its other end part.C-shaped receiving portion is adapted to and cloth
The bottom engagement in the cylindrical part and bracket 42 for pinching the second fixing device 4 on wheel 41 is put, these parts are not in fig. 2
It is shown in detail.
For the fine setting of the position that allows pivot axis 9, miniature rib 73 is located on the upper surface of C-shaped receiving portion 71, such as
Shown in Fig. 4 B, the miniature rib provides tactile response for surgeon and also provides the second pivotable support section 7 more
Reliable rotation regulation.Once rotating shaft member is finally determined by operating personnel, surgeon or any other staff etc.
Position, be located at the position that the locking mechanism at the second fixing device 4 allows to fix rotating shaft member.The determination uses drill jig
10 perform, as shown in Figure 14 and such as following described in reference diagram 6.
The drilling apparatus of pivoting device 8 and the tube portion 12 with drilling tool 11 and with drill bit is shown in greater detail in Fig. 5.Pivot
Device 8 include junction portion 83, the junction portion have level protrude ledge 86 and be located at hole 86 therein so as to
Pushed away on the pin-shaped rotary support member 72 of the second pivotable support section 7.Therefore, pivoting device 8 is limited to around pivot
Approximate horizontal pivoting action of the axis 9 relative to main support member 2.The details of motion and boring procedure is shown in Figure 15 and 16.
Pivoting device 8 is for example with two parallel bars 81,82 stretched out from junction portion 83.In the other end of bar 81,82
At portion, ring 84 is integrally formed, the ring is configured to keep and receives the tube portion 12 of drilling apparatus.When tubular body 125 connects
Pivoting device 8 can be fixed to by tube portion 12 by being received in screw 85 when in ring 84.
Tube portion 12 includes having predetermined bend radius rcCircular arc tubular body 125, the radius of curvature corresponds to
It from pivot axis 9 with a distance from, i.e. from pivot axis and joint 83 by bar 81,82 until ring 84 and tubular body 125
Respective central axis pivoting device 8 total length.The pivot of pivoting device 8 makes arc longitudinal direction of the tube portion 12 along its own
Central axis is moved.Radius of curvature rcIt is equal to or more than 130mm in a specific embodiment and equal to or less than 240mm,
And in additional embodiment, more preferably equal to or greater than 140mm, or equal to or more than 150mm, and/or more preferably etc.
In or less than 210mm.
In the end of tube portion 12, there is provided the drill bit 126 for allowing to pierce in bone material.Drill bit 126 is for example via configuration
Spiral shape driving cable into the internal rotating in tubular body 125 is driven.There is provided brill at the other end of driving cable
The adapter of tool 11, the adapter is by the motor from drilling tool 11（Do not show）Rotary motion be delivered to driving cable.Bag
Include drilling tool and be similar to the details of the drilling apparatus of instrument as used in this article in bibliography US2010/0292722A1
In describe in detail, above-mentioned patent by quote intactly be incorporated in herein.
The handle 114 of boring device 11 allows surgeon to grasp drilling apparatus and promotes drilling apparatus and pivot forward
Arm 8 is so that drill bit 126 and tube portion 12 are advanced in bone.Operated key 111,112 and 113 allows surgeon to adjust brill respectively
Machine intensity, pattern（moot）And direction.Numeral 110 indicates battery, and boring device 11 is shown as wireless drilling tool.
Fig. 6 shows the drill jig 10 with tubular portion 102, and the tubular portion is vertically supported by the rotation of axle 7
Part 72.As described above, drill jig 10 can be replaced by pivoting device 8 during use, or the attached of pivoting device can be used as
Plus be provided.Therefore, drill jig 10 has the identical pivot axis 9 of pivoting device 8 with keeping drilling apparatus.Moreover, drill point
Tool 10 has horizontal arm 100, and is located at the holder part of the end of arm 100, and the horizontal arm, which has to correspond to, pivots dress
Put 8 length.Holder part 101 is in the hole for indicating to get out in underlying bone component during use of targeting device
Positioning, referring to Figure 14.Therefore, circular arc holder part 101 approximately along with the pipe portion with drill bit 126 and tubular body 125
12 identical circular paths are divided to pivot.The construction allows surgeon to recognize the hole that will be got out relative to bone component from top（
Herein：Calcaneum, astragalus, shin bone）Position, and as response, if necessary to correct, then reposition axle 7 and pivotal axis
Line 9.
It should be noted that holder part 101 is visible in X-ray, and targets device and can be used in combination with x-ray tool
Holder part 101 is covered to allow surgeon used in visible bone in X-ray.
It is shown using the method for targeting device and drilling apparatus in Fig. 8 to 16.First step is shown in fig. 8,
Wherein prepare heel to be fixed and fix the anchor 13 with tulip shaped head 130 as described above in inner side respectively
At astragalus 15 and at calcaneum 14.It should be noted that the bone anchor assembly corresponding to calcaneum is inserted in its axial end, rather than insertion
In its sole end face.
Fig. 8 shows side view, and Fig. 9 and 10 shows forward sight and rearview respectively.
As shown in Figure 11, using the Kirschner wire 17 of dotted line is designated as to reposition the fragment of bone or bone respectively.
In the next step shown in Figure 12 A, heel is installed to targeting device 1 between two fixing devices 3,4
Main support member 2 causes spherical head 38,47 to face the corresponding tulip shaped head 130 of bone anchor assembly.It should be noted that the configuration is permitted
Perhaps right crus of diaphragm with left foot identical mode to be installed in device, i.e. in both cases with flat-hand position installation foot.
Carried in addition, the vertical portion 39 and 45 of the first and second fixing devices is respectively pin 37,46 and spherical head 38,47
For height so that be also the plane of tube portion 12 and arcuate socket to be got out pivoting device 8 pivot plane interior side draw to
Upper to intersect with bone component, this allows hole safely to extend through calcaneum, astragalus and shin bone.Pin 37,46 or spherical head 38,47
Height can be with different from each other.
In this embodiment, relative to three fixing devices of the pin 37 and spherical head 38 of the first fixing device are moved wherein
The plane or pivoting device 8 that the pivotable support section 5 and 7 of dynamic plane and/or first and second rotates wherein are revolved wherein
The plane turned（Each of these planes in this embodiment is parallel to each other）Vertical height than pin 46 and spherical head 47
Vertical height in the vertical direction goes out greatly specific range.When the most suitable position in the corresponding bone 14,15 of solid 13 insertion of bone anchor, such as
Shown in Fig. 8-10, as described above, this advantageously assures that the orientation of pin and bone component relative to the plane of arcuate socket to be got out
Inclination.
Then, the tulip shaped head 130 of the bone anchor assembly 13 in insertion calcaneum 14 is buckled in the second fixing device 4 first
Spherical head 47 on, referring to Figure 12 B.Then, the bracket 32 of the first fixing device 3 is moved towards astragalus to have inserted astragalus
The tulip shaped head 130 of bone anchor assembly 13 in 15 is buckled in the spherical head 38 of the first fixing device 3.Then, bracket
32 are locked along the position of guide rail 20,21.In the stage, realize that fix at 2 points.
Then, as shown in Figure 13, Si Shi screws 17 are laterally fixed in shin bone and the first pivoting device 5 is attached
It is connected to the first fixing device 3 being located at the rotatable main support member 2 of axis 91.3rd fixing device 6 then slide with
Receive the head point of Si Shi screws 17.The receiving portion 63 of 3rd fixing device 6 is locked and along the bracket of elongate bars 50
62 position is also locked.In the step, set up at 3 points and fixed.
As shown in Figure 14, the second pivotable support section 7 is attached to main support member 2（Referring to the arrow C in Figure 14）, and
And the drill jig 10 with its tubular portion 102 is installed to the rotary support member 72 of the second pivotable support section 7.Then, lead to
Cross and holder part 101 is covered on heel（Referring to arrow E）, by making in the holder part 101 and component of drill jig 10
The desired locations in hole are overlapped, and determine the rotation position of the second pivotable support section 7（Referring to arrow D）.Therefore, x-ray tool
Allow operator or surgeon or other people recognize the position of corresponding bone, thus holder part 101 and its scale of covering hold
It is easily visible.Optional rib pattern 73 allows fine setting.Once having determined that desired rotational position, the second pivotable support section 7 is locked.
As shown in Figure 15, drill jig 10 is removed and replaced with drilling apparatus（Referring to arrow F）, the drilling apparatus
Tube portion 12 including drilling tool 11 and with circular arc tubular body 125 and drill bit 126.Then operation drilling tool 11 is with rotary drilling-head
126 and clockwise promote pivoting device 8（Referring to arrow G）.Drill bit 126 enters calcaneum 14 by the end face of calcaneum.
As shown in Figure 16, by being compared with the determination based on the scale progress being located on holder part 101 by being located at
Scale at pipe determines end points.Thus, tibial cut arc-shaped hole is entered by astragalus in calcaneum.
As shown in Figure 17, metapedes then is removed from framework and major part, anchor 13 and Si Shi spiral shells can also be removed
In nail 17 and the arc-shaped hole that can will be followed closely 19 insertions therefore be formed.
Target device or its part can be by any suitable material, particularly stainless steel, titanium, titanium alloy or bio-compatible
The formation such as plastics or elastomeric material.The rubber or similar material for providing and grasping can also be provided.
Targeting device can also be combined as external member offer with bone anchor assembly as described herein.
In the above-described embodiment, tube portion 12 is designed to circular arc.However, according to modification, arc can not also
It is circular.For example, radius of curvature rcIt can change along the central axis of tube portion 12 or the specific of tube portion can be directed to
Section obtains different value.According to another modification, moving pivotally can be translated by the combination of tube portion（For example, radially）With rotation fortune
It is dynamic to set up to obtain arcuate socket.
In the embodiment above, main support member 2 is provided by two guide rails 20,21.According to modification, only one can be provided
Guide rail or bigger platform, wherein fixing device can be by other means, for example in ratchet or platform setting it is multiple solid
Determine hole regulation.
In the embodiment above, the first and second pivotable support sections 7 and 8 are provided to be connected to main branch via joint
Support member 2.However, can also be made according to modification, including the framework of main support member 2 and the first and second pivotable support sections 7 and 8
It is provided for single element, it allows translation or rotational positioning of at least three fixing devices on common flat, as described above.
In the embodiment above, three fixing devices are provided as the part independently of main support member.However, according to repairing
Change, one or more of fixing device can also be provided as the integral part of main support member or framework, wherein main support
Part or framework integrally allow to adjust the mutual distance between fixing device or their mutual rotation position.
In the embodiment above, the specific arrangements for receiving portion and bone anchor assembly have been described.However, according to modification,
It is also possible that with other connections and fixed mechanism.For example, each of at least three fixing devices can include may be connected to bone
The spherical head of the tulip shaped head of anchor.Similarly, bone anchor assembly can include in spherical head and fixing device
It is one or more including tulip shaped head.In addition, one or more of bone anchor assembly may be coupled to bar or plate, and
Bar or plate are received by the receiving portion of corresponding fixing device.
Moreover, according to another modification, 4,5,6 so that more fixing devices can be provided to targeting device.
In the embodiment above, it describe in detail the targeting device for being drilled in people's metapedes.However, as herein
The targeting device of proposition is also applied for the other parts of human body.Moreover, the hole got out using targeting device is without the need for nail.
On the contrary, teaching also includes other application as described herein, for example formed before any bone for reaching human body, it is internal or
The path of specific part below.
Claims (15)
1. a kind of targeting device (1) for being used to guide drilling apparatus, the drilling apparatus is used for the group in adjacent bone or bone chip
Arcuate socket is formed in part, the targeting device includes：
Support frame；
Pivoting device (8), the pivoting device is installed to the support frame and is arranged to receive the drilling apparatus and permits
Perhaps described drilling apparatus is along with predetermined bend radius (rc) curved path surround pivot axis (9) pivoting action；
Wherein described support frame carries at least three fixing devices (3；4；6), when bone component is installed to the support frame,
Each fixing device is configured to fix one of bone (14 of bone component respectively；15；16) or fragment, to be pivoted relative to described
Device (8) limits the fixed position of the bone component in space.
2. targeting device (1) according to claim 1, wherein：
At least three fixing device (3；4；6) the first fixing device (3) and the second fixing device (4) is located at main support member
(2) on, the main support member includes at least one guiding piece (20；21), at least one described guiding piece (20；21) it is configured to permit
Perhaps slidably regulation of the first fixing device (3) relative to the position of the second fixing device (4).
3. targeting device (1) according to claim 2, wherein：
The 3rd fixing device (6) in the fixing device is provided as being slidably disposed at first before locking pivotable
On support section (5), the first pivotable support section (5) is arranged to relative to the main support member (2) in monoplane
It is rotatable.
4. targeting device (1) according to claim 3, wherein：
At least three fixing device (3；4；One or more of 6) part for including being arranged to receiving bone anchor assembly
Receiving portion, the bone anchor assembly is configured to be anchored at the corresponding bone (14 of bone component；15；16) or in fragment.
5. targeting device (1) according to claim 4, wherein：
First fixing device (3) and the second fixing device (4) carry receiving portion, and the receiving portion is configured to ball
(38；47) and it is arranged as hollow tulip shaped head (130) of the snap device respectively with the bone anchor assembly (13) and matches somebody with somebody
Close.
6. targeting device (1) according to claim 4, wherein：
3rd fixing device (6) includes being formed as the receiving portion in hole, for receiving the Si Shi spiral shells in bone to be anchored to
Follow closely the shaft-like head of (17).
7. the targeting device (1) according to one of claim 3 to 6, wherein：
The pivoting device (8) for being arranged to allow the pivoting action of the drilling apparatus is arranged to be rotationally supported at second
On pivotable support section (7),
Wherein described second pivotable support section (7) itself relative to main support member (2) in monoplane pivotably, to adjust
Save in position of the rotary support member relative to bone component of the pivoting device (8),
Wherein described second pivotable support section (7) can be locked relative to the Angle Position of the main support member (2).
8. targeting device (1) according to claim 7, wherein：
The first pivotable support section (5) is configured to connect to first fixing device (3)；And/or
The second pivotable support section (7) is configured to connect to second fixing device (4).
9. targeting device (1) according to claim 7, it also includes：
For the drill jig (10) for the position for indicating the arcuate socket, wherein the drill jig (10) is configured to be rotationally supported at
On the second pivotable support section (7), so as to be pivoted around with the pivoting device (8) identical pivot axis (9).
10. targeting device (1) according to claim 9, wherein：
The drill jig (10) includes the part (101) with arc, and the arc has radius of curvature (rc), so that when bone group
Part allows to determine the position of hole to be got out relative to bone component when being installed to the support frame.
11. the targeting device (1) according to one of claim 1 to 6, it includes：
The drilling apparatus of the pivoting device (8) is may be mounted to, wherein the drilling apparatus also includes：
Boring device (11), the boring device is arranged to provide rotary motion；
Circular arc tubular body (125), the circular arc tubular body has the end for being connected to the boring device (11), and
The circular arc tubular body is extended through for transmitting the device of rotary motion；
Drill bit (126), the drill bit is located at relative with the end for being connected to the boring device (11) of the tubular body another
An end portion, the drill bit is connected to the device for being used to transmit rotary motion so that when the pivoting device (8) surrounds institute
State to work as when pivot axis (9) is pivoted and the drilling apparatus is advanced to bone (14；15；16) it is easy to response when in from rig dress
The rotary drilling of transmission is put to the marrow in component.
12. targeting device (1) according to claim 11, wherein：
The circular arc tubular body (125) is approximately along its whole length with predetermined bend radius (rc) extension.
13. targeting device (1) according to claim 11, wherein：
When the drilling apparatus is installed to targeting device (1), the circular arc tubular body (125) is configured to by institute
State at least three fixing devices (3；4；6) extend in the plane that the direction of motion is limited.
14. the targeting device (1) according to one of claim 1 to 6, wherein：
Radius of curvature (the rc) it is at least 130mm.
15. the targeting device (1) according to one of claim 1 to 6, wherein：
Radius of curvature (the rc) it is equal to or less than 240mm.
Applications Claiming Priority (4)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| US201261726358P | 2012-11-14 | 2012-11-14 | |
| US61/726,358 | 2012-11-14 | ||
| EP12192679.4 | 2012-11-14 | ||
| EP12192679.4A EP2732777B1 (en) | 2012-11-14 | 2012-11-14 | Targeting device for guiding a drill arrangement |
Publications (2)
| Publication Number | Publication Date |
|---|---|
| CN103800049A CN103800049A (en) | 2014-05-21 |
| CN103800049B true CN103800049B (en) | 2017-09-12 |
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ID=47191596
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| Application Number | Title | Priority Date | Filing Date |
|---|---|---|---|
| CN201310556203.4A Active CN103800049B (en) | 2012-11-14 | 2013-11-11 | Targeting device for guiding drilling apparatus |
Country Status (7)
| Country | Link |
|---|---|
| US (1) | US9592064B2 (en) |
| EP (1) | EP2732777B1 (en) |
| JP (1) | JP6207349B2 (en) |
| KR (1) | KR20140062418A (en) |
| CN (1) | CN103800049B (en) |
| ES (1) | ES2552940T3 (en) |
| TW (1) | TW201427636A (en) |
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| EP2732777B1 (en) * | 2012-11-14 | 2015-09-16 | Biedermann Technologies GmbH & Co. KG | Targeting device for guiding a drill arrangement |
| US9814473B2 (en) | 2014-09-11 | 2017-11-14 | Wright Medical Technology, Inc. | Guidance system and method for bone fusion |
| CN107106255B (en) * | 2014-12-12 | 2019-04-16 | 医科达公司 | Stereotactic surgery instrument |
| CN105997228B (en) * | 2015-04-14 | 2018-11-16 | 青岛亿嘉诺日化有限公司 | A kind of dentoid process of axis's sighting device with twin nuclei |
| US10357314B2 (en) | 2015-07-08 | 2019-07-23 | Stryker European Holdings I, Llc | Instrumentation and method for repair of a bone fracture |
| CN105411696A (en) * | 2016-01-07 | 2016-03-23 | 张英怀 | Implant implanting guiding device for tooth implanting |
| CN108463183B (en) | 2016-01-12 | 2022-02-18 | 直观外科手术操作公司 | Segmented force feedback transitions between control states |
| CN108697472B (en) * | 2016-02-19 | 2021-06-25 | 桑尼布鲁克研究所 | Positioning and alignment instrument for introducing a surgical device into a bone |
| CN106108975B (en) * | 2016-08-24 | 2018-09-28 | 青岛市中心医院 | Bone object is bored in interior moulding |
| EP3444058A1 (en) * | 2017-08-18 | 2019-02-20 | Power Box AG | Jig apparatus for use in forming holes in a workpiece in a guided manner and method of forming a hole in a workpiece |
| CA3094122C (en) * | 2018-04-04 | 2023-03-21 | Wright Medical Technology, Inc. | Minimally invasive displacement osteotomy system and method |
| WO2020117327A1 (en) * | 2018-12-03 | 2020-06-11 | Wright Medical Technology, Inc. | Minimally invasive guides and cutting instruments |
| US20230055767A1 (en) * | 2020-03-30 | 2023-02-23 | Wright Medical Technology, Inc. | Targeting guide and associated method |
| FR3117328B1 (en) * | 2020-12-14 | 2023-03-24 | Novastep | Reusable instrumentation for osteosynthesis surgery, in particular of the hallux valgus |
| CN113768579B (en) * | 2021-09-29 | 2023-04-07 | 成鹏 | Reaming device for orthopedic medical treatment |
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Also Published As
| Publication number | Publication date |
|---|---|
| KR20140062418A (en) | 2014-05-23 |
| EP2732777B1 (en) | 2015-09-16 |
| US9592064B2 (en) | 2017-03-14 |
| EP2732777A1 (en) | 2014-05-21 |
| CN103800049A (en) | 2014-05-21 |
| JP2014097383A (en) | 2014-05-29 |
| JP6207349B2 (en) | 2017-10-04 |
| US20140142582A1 (en) | 2014-05-22 |
| TW201427636A (en) | 2014-07-16 |
| ES2552940T3 (en) | 2015-12-03 |
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